Financial Assistance

We’re Here to Help

Thank you for choosing Alice Peck Day Memorial Hospital. Our mission is to serve you and the community with the best possible health care. Hospital charges and insurance statements can be hard to understand. We want to help you be ready for your visit in all ways, including the financial aspects.

If you’re not sure how you’re going to pay your bill, we will provide you with information and contacts for a number of programs that may help you. Our staff will help you with the application process when we can. To get an application, visit the Patient Access Department at APD, call (603) 448-3121 to ask for the forms to be mailed to you, or download the Financial Aid Cover Letter & Financial Assistance Application Form.

APD Financial Assistance Programs

The program helps insured and uninsured patients whose household incomes are at or below 200% of the Federal Poverty Guidelines with 100% APD financial assistance. There is a sliding scale for those who qualify for up to 300% of Federal Poverty Guidelines. Please review this chart for more information.

To get an application, visit the Patient Access Department at APD, or call (603) 448-3121. APD financial assistance guidelines are updated each year to reflect changes in the Federal Poverty Guidelines.

APD Discount and Payment Plan Programs

Our payment plan helps patients who realize they cannot pay before their treatment or within 30 days of receiving their first statement. The payment calendar will be based on the amount of money that is due. We may ask for a “good faith” payment on arrangements that will last more than six months. If you are unable to make full payment, please call the telephone number on your patient statement.

APD offers uninsured patients an automatic 15% discount, which will be reflected on your first patient statement.

A 10% prompt-pay discount will be applied if you pay your patient balance in full within 10 days of receiving your patient statement.

You must apply and APD must verify your application before you qualify for any of these programs or discounts.

To get an application, visit the Patient Access or call (603) 448-3121.

Price Estimates for Services at APD

You may ask for a price estimate at any time for all services provided at APD. For certain services, you will get a letter in the mail from the Patient Access Department after your care has been scheduled that includes the estimated price of your upcoming service.

The estimate can help you in planning payment arrangements.

You may be billed separately for professional services provided by physicians, nurse practitioners, midwives or anesthesia professionals not employed by APD. These charges will not be included in estimates provided by the hospital, so you should also ask these providers for their estimates if you need them. The Patient Access team can help you if you aren’t sure which providers you need to ask for an estimate.

New Hampshire Health Access Network

The New Hampshire Health Access Network is a voluntary effort by health care providers to improve access to health care for low-income children and adults statewide. NHHAN is not an insurance program. It is a discount program based on the applicant household's income and assets. The Network helps low-income people in New Hampshire who do not have health insurance or do not have enough money to pay for hospital care, doctor visits or other medical care.

Contacts for Obtaining Medical Insurance/Prescription Assistance

Medicaid of NH

A federal and state-funded program that serves needy individuals and families who meet financial and other eligibility requirements, or individuals who lack adequate resources to pay for medical care.